Healthcare Provider Details

I. General information

NPI: 1407767460
Provider Name (Legal Business Name): KELLY LEA COCHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3265 STRATTON FRK
CANADA KY
41519-8337
US

IV. Provider business mailing address

3265 STRATTON FRK
CANADA KY
41519-8337
US

V. Phone/Fax

Practice location:
  • Phone: 276-341-2811
  • Fax:
Mailing address:
  • Phone: 276-341-2811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: